Name of Facility: __________________________________ MPI # on Certificate of Compliance: __________________ County: _____________________ STARS WORKSHEET STAR 4 Accreditation – School Age Child Care (SACC) Instructions: In order to receive a designation at this level, all STARS Performance Standards for STAR 4-Accreditation must be met and the facility must provide documentation of its accreditation status. STARS staff will need to see site-specific documentation (sources of evidence) of each STARS Performance Standard in order to verify the achievement of that STARS Performance Standard. The facility must notify the Regional Key immediately of any change in accreditation status including letters of extension. Equivalencies for School-Age (SACC) programs are listed throughout the worksheets. Please contact your Regional Key for more information regarding paperwork. SACC only sites should use these worksheets. Group Homes that have a mix of SACC and Early Learning components should contact the Regional Key for assistance. This worksheet will help you to compile the information and paperwork necessary for designation. During your designation visit, STARS staff may use other methods to confirm that a standard is met. For example, if the standard requires a piece of paperwork, STARS staff may ask questions to verify the document. If moving up a STAR Level you will receive an ERS assessment as part of your STARS Designation. The ERS score will be effective for two (2) years and you must have the next ERS assessment prior to the current ERS scores expiring. Assessors will make every effort to coordinate the assessment visit so that it does not coincide with an accreditation validation visit. Please review the information in the Clarifications* section at the end of this document. All documentation must be completed for the individual DHS-certified facility and the staff that are employed at that facility. It is important to organize all documentation and keep it all in one place. Arranging the paperwork in a file box or a binder will make it easier for you to keep track of it and allow the designation visit to go smoothly. The table below includes 3 columns– 1. STARS Performance Standard & Documentation column – Each Performance Standard is located in this column and is the exact wording found in the Standards document. The STARS Performance Standards build upon one another as you move up the STAR Levels. Therefore, there are STAR 1, STAR 2, and STAR 3 standards included in the STAR 4 standards. These standards are italicized with the STAR level in parentheses. Under each standard, there are checkboxes to help you keep track of the items needed for the designation visit. You also will notice that certain standards have a note to let you know that there is an optional tool available to help meet the standard. 2. Pre-Designation Notes column – There are important notes in this column to help you prepare. Please use this column during your predesignation preparation to help keep track of your progress. In the comments section, feel free to write specific notes or explanations. Many SACC equivalencies will be listed in this section. 3. Designation Notes column – STARS staff will use this column during your STAR 4 designation visit. There also is a section for comments where specific guidance can be provided. You will see optional tools listed throughout the worksheet. These tools are listed with the individual standards that they were designed to help you meet. There is also a required tool at the end of this worksheet, called the STARS Enrollment Calculation Tool. This tool is required for designation and to request Financial Awards. Finally, there is a tool that will help in more than one section of the Performance Standards. It is the STARS Goal Planning Tool. All of the optional tools are available at www.pakeys.org or by contacting your STARS representative. 1 Pennsylvania Core Knowledge Competencies for Early Childhood and School Age Professionals (CKC) replaced Core Body of Knowledge 2 Pennsylvania Big Ideas Framework (Big Ideas) and 3 Individual Professional Development Plan for Early Childhood and School-Age Professionals (IPDP) transition from Professional Development Record (PDR) July 1, 2014 to July 1, 2015 at which time it will be required for Keystone STARS providers. Copies of the PDR will no longer be available for ordering or downloading. * Please see the Clarifications section beginning on page 12 of this worksheet. WS4A-02 – SACC 7/1/15 Page 1 of 13 Name of Facility: __________________________________ MPI # on Certificate of Compliance: __________________ County: _____________________ After you have completed all necessary items in this worksheet, please refer to the Next Steps section. This includes a summary of the documentation that you will need to submit to request a STAR designation. If you have questions or concerns during any part of this process, please do not hesitate to contact your Regional Key for assistance. STARS Performance Standard & Documentation Pre-Designation Notes Designation Notes Director* Qualifications Pre-Designation Date: ___________ Designation Date: _________ 1. Complete professional development on the Pennsylvania Core Knowledge Competencies for Early Childhood and School Age Professionals (CKC)/ Pennsylvania Big Ideas Framework (Big Ideas) and Individual Professional Development Plan for Early Childhood and School-Age Professionals (IPDP) and Foundations of the Environment Rating Scale (ERS). (STAR1) STARS approved professional development certificates CKC/Big Ideas/IPDP for Directors Foundations of the ERS *Note: PDR will remain in effect until June 30, 2015. Copies of the PDR will no longer be available for ordering or downloading as of July 1, 2014. During 7/1/14-7/1/15 will be the transition from PDR to using Big Ideas and IPDP. Notes: Directors hired within the 12 months prior to designation have 12 months after their directorship start date to complete the CKC/Big Ideas/IPDP and foundations of the ERS professional development If ITERS, ECERS or SACERS was taken before July 2007, credit for Foundations of ERS is given. Director’s Initials:___________ CKC/Big Ideas/IPDP Completed: Date_________ Hrs_____ Foundations of ERS Completed: Date_________ Hrs_____ CKC/Big Ideas/IPDP Completed: Yes □ No □ Foundations of ERS Completed: Yes □ No □ Comments: Good Good Better Better Best Best 1 Pennsylvania Core Knowledge Competencies for Early Childhood and School Age Professionals (CKC) replaced Core Body of Knowledge 2 Pennsylvania Big Ideas Framework (Big Ideas) and 3 Individual Professional Development Plan for Early Childhood and School-Age Professionals (IPDP) transition from Professional Development Record (PDR) July 1, 2014 to July 1, 2015 at which time it will be required for Keystone STARS providers. Copies of the PDR will no longer be available for ordering or downloading. * Please see the Clarifications section beginning on page 12 of this worksheet. WS4A-02 – SACC 7/1/15 Page 2 of 13 Name of Facility: __________________________________ MPI # on Certificate of Compliance: __________________ County: _____________________ STARS Performance Standard & Documentation Pre-Designation Notes Designation Notes 2. Complete professional development in the ERS scales appropriate to age groups in the facility. (STAR2) Notes: Directors hired within the 12 months prior to designation have 12 months after their directorship start date to complete professional development in the ERS scales appropriate to the facility. To determine which ERS is appropriate to your facility, please contact the Regional Key. Director’s Initials:___________ ECERS Completed: Date Hrs SACERS Completed: Date Hrs Foundations Completed: Yes □ No □ ECERS Completed: Yes □ No □ SACERS Completed: Yes □ No □ Comments: STARS approved professional development certificates for SACERS scales STARS approved professional development certificates for ECERS scales SACERS (for majority 1st grade and up) ECERS (if majority Kindergarten or separate Kindergarten class) Notes: • Effective July 1, 2015, SACERS training will be transitioning to SACERS-U. • In fiscal year 2015-2016, ECERS-R training will be transitioning to ECERS-3 training effective April 1, 2016. Good Better Best Good Better Best 1 Pennsylvania Core Knowledge Competencies for Early Childhood and School Age Professionals (CKC) replaced Core Body of Knowledge 2 Pennsylvania Big Ideas Framework (Big Ideas) and 3 Individual Professional Development Plan for Early Childhood and School-Age Professionals (IPDP) transition from Professional Development Record (PDR) July 1, 2014 to July 1, 2015 at which time it will be required for Keystone STARS providers. Copies of the PDR will no longer be available for ordering or downloading. * Please see the Clarifications section beginning on page 12 of this worksheet. WS4A-02 – SACC 7/1/15 Page 3 of 13 Name of Facility: __________________________________ MPI # on Certificate of Compliance: __________________ County: _____________________ STAFF QUALIFICATIONS & PROFESSIONAL DEVELOPMENT STARS Performance Standard & Documentation Director* Development 1. Annually participate in 3 professional growth and development activities.* Membership card, certificate, meeting minutes, certificate of attendance, or other documentation of the listed professional development activities STARS staff may interview director during the designation visit to discuss staff participation in professional growth and development activities List activity beside each check box: __________________________________________ __________________________________________ __________________________________________ Pre-Designation Notes Note: Directors hired within the 12 months prior to designation have 12 months after their directorship start date to complete. Verified: Yes □ No □ Comments: Good Better Best Designation Notes Verified: Yes □ Comments: Good Better No □ Best 1 Pennsylvania Core Knowledge Competencies for Early Childhood and School Age Professionals (CKC) replaced Core Body of Knowledge 2 Pennsylvania Big Ideas Framework (Big Ideas) and 3 Individual Professional Development Plan for Early Childhood and School-Age Professionals (IPDP) transition from Professional Development Record (PDR) July 1, 2014 to July 1, 2015 at which time it will be required for Keystone STARS providers. Copies of the PDR will no longer be available for ordering or downloading. * Please see the Clarifications section beginning on page 12 of this worksheet. WS4A-02 – SACC 7/1/15 Page 4 of 13 Name of Facility: __________________________________ MPI # on Certificate of Compliance: __________________ County: _____________________ STAFF QUALIFICATIONS & PROFESSIONAL DEVELOPMENT STARS Performance Standard & Documentation 2. 27 annual clock hours of professional development based on the PDR, including the Director’s section. (This is 6 additional clock hours above the STAR 3 requirement; 21 clock hours must be based on the PDR. Also, 3 of the clock hours must be in management, professionalism, supervision, leadership, and/or administration.) Documentation of STARS approved professional development including information such as course title, hours, and instructor signature 3 hours in management, professionalism, supervision, leadership, and/or administration 21 hours of STARS approved professional development match the needs in PDR Pre-Designation Notes Designation Notes Notes: Verified: Yes □ No □ Completion of college credit hours will count toward Comments: annual clock hours of professional development. The hours allotted will be as follows: 1 credit = 15 annual clock hours. Annual clock hours include professional development that has occurred in the 12 months prior to the designation visit. These hours may follow a staff person from one STARS facility to another, as long as the hours are taken within the year prior to designation and are aligned with the individual’s PDR and the ages of children served. Director hired within the 12 months prior to designation have 12 months after their directorship start date to complete annual clock hours. Fire and Water Safety do not count toward the required annual clock hours. Pediatric First Aid and CPR does not count toward the required annual clock hours. Emergency Preparedness training counts towards hours, as long as it was not already included toward meeting certification requirements. Self-learning modules require 6-8 weeks to process and receive certificates. For designation purposes, a copy of the completed module and returned mail receipt will be acceptable. However, a copy of the professional development certificate must be submitted to the Regional Key when received. SACC: It is recommended that Directors of SACC programs attend “Using Portfolios to Bring Out the Best in School Age Children” as part of their annual hours. Verified: Yes □ Comments: Good No □ Good Better Better Best Best 1 Pennsylvania Core Knowledge Competencies for Early Childhood and School Age Professionals (CKC) replaced Core Body of Knowledge 2 Pennsylvania Big Ideas Framework (Big Ideas) and 3 Individual Professional Development Plan for Early Childhood and School-Age Professionals (IPDP) transition from Professional Development Record (PDR) July 1, 2014 to July 1, 2015 at which time it will be required for Keystone STARS providers. Copies of the PDR will no longer be available for ordering or downloading. * Please see the Clarifications section beginning on page 12 of this worksheet. WS4A-02 – SACC 7/1/15 Page 5 of 13 Name of Facility: __________________________________ MPI # on Certificate of Compliance: __________________ County: _____________________ STAFF QUALIFICATIONS & PROFESSIONAL DEVELOPMENT STARS Performance Standard & Documentation Staff* Development 1. For each Teacher/Assistant Teacher, 24 annual clock hours of professional development* based on IPDP; each Aide, 15 clock hours based on IPDP. (For Teachers/Assistant Teachers, this is 9 additional annual clock hours above the STAR 3 requirement and 18 of these clock hours must be based on the PDR. Each Aide needs 15 clock hours based on PDR, which is 3 above STAR 3) Teacher/Assistant Teacher – Each has additional 18 annual clock hours above the number to meet DHS regulations Aides – Each has additional 9 annual clock hours above the number to meet DHS regulations Professional development has occurred within the past 12 months The additional hours of Keystone STARS approved professional development match the needs in the PDR. Documentation of Keystone STARS approved professional development including information such as course title, hours, and instructor signature. List the number of annual clock hours on the Staff Records Grid. See column P.] Pre-Designation Notes Notes: Designation Notes Verified: Yes □ No □ Completion of college credit hours will count toward Comments: annual clock hours of professional development. The hours allotted will be as follows: 1 college credit = 15 annual clock hours. Staff working less than 500 hours per year and volunteers/substitutes working more than 500 hours per year must take 12 annual clock hours. Staff hired within the 12 months prior to designation have 12 months after date of hire to complete annual clock hours. Fire and Water Safety do not count toward the required annual clock hours. Emergency Preparedness training counts towards hours, as long as it was not already included toward meeting certification requirements. Pediatric First Aid and CPR does not count toward the required annual clock hours. Self-learning modules require 6-8 weeks to process and receive certificates. For designation purposes, a copy of the completed module and returned mail receipt will be acceptable. However, a copy of the Professional development certificate must be submitted to the Regional Key when received. SACC: The content of staff professional development needs to be appropriate for the age groups served. Verified: Yes □ No □ Comments: Good Better Best Good Better Best 1 Pennsylvania Core Knowledge Competencies for Early Childhood and School Age Professionals (CKC) replaced Core Body of Knowledge 2 Pennsylvania Big Ideas Framework (Big Ideas) and 3 Individual Professional Development Plan for Early Childhood and School-Age Professionals (IPDP) transition from Professional Development Record (PDR) July 1, 2014 to July 1, 2015 at which time it will be required for Keystone STARS providers. Copies of the PDR will no longer be available for ordering or downloading. * Please see the Clarifications section beginning on page 12 of this worksheet. WS4A-02 – SACC 7/1/15 Page 6 of 13 Name of Facility: __________________________________ MPI # on Certificate of Compliance: __________________ County: _____________________ STAFF QUALIFICATIONS & PROFESSIONAL DEVELOPMENT STARS Performance Standard & Documentation 2. Annually, all staff involved in two professional growth and development activities.* Membership card, certificate, meeting minutes, certificate of attendance, or other documentation of at least two professional growth activities for each staff member STARS staff may interview the director during the designation visit to discuss participation in professional growth activities Pre-Designation Notes Designation Notes Note: Staff hired within the 12 months prior to designation have 12 months after date of hire to complete. Verified: Yes □ No □ Comments: Verified: Yes □ Comments: Good Good Better Best Better No □ Best 1 Pennsylvania Core Knowledge Competencies for Early Childhood and School Age Professionals (CKC) replaced Core Body of Knowledge 2 Pennsylvania Big Ideas Framework (Big Ideas) and 3 Individual Professional Development Plan for Early Childhood and School-Age Professionals (IPDP) transition from Professional Development Record (PDR) July 1, 2014 to July 1, 2015 at which time it will be required for Keystone STARS providers. Copies of the PDR will no longer be available for ordering or downloading. * Please see the Clarifications section beginning on page 12 of this worksheet. WS4A-02 – SACC 7/1/15 Page 7 of 13 Name of Facility: __________________________________ MPI # on Certificate of Compliance: __________________ County: _____________________ LEARNING PROGRAM STARS Performance Standard & Documentation Pre-Designation Notes Designation Notes Environment Rating 1. The average facility score of all sampled classrooms/age groups assessed by a STARS ERS assessor must be a 5.00. Facility report from Keystone STARS ERS Assessor indicates an average facility score for all sampled classrooms is at least a 5.00. Note: Effective August 1, 2015 through June 30, 2017. Center-based programs with preschool that are due to have their current ERS Scores renewed, will be assessed using the new ECERS-3 and have their current ERS Scores extended for a two year period for use in determining STAR level. If the site offers school-age programming, one assessment using the SACERS-U will be completed. Center based programs with preschool that are attempting to move up a STAR level will be assessed using the ECERS-R and all other applicable program ERS assessments until June 30, 2016. Beginning July 1, 2016 Center-based programs with preschool that are attempting to move up a STAR level, will be assessed using ECERS-3 and all other applicable program ERS assessments. Effective July 1, 2015-June 30, 2016 School-Age only programs may choose to have a SACERS or a SACERS-U assessment for purposes of STARS Movement or ERS Score Renewal. Effective July 1, 2016, School-Age programs will be assessed using SACERS-U. Note: This is not required to request designation. An ERS assessment will be scheduled once your Regional Key designates all other STARS performance standards. Verified: Yes □ No □ Comments: Good Better Best Verified: Yes □ Comments: Good Better No □ Best 1 Pennsylvania Core Knowledge Competencies for Early Childhood and School Age Professionals (CKC) replaced Core Body of Knowledge 2 Pennsylvania Big Ideas Framework (Big Ideas) and 3 Individual Professional Development Plan for Early Childhood and School-Age Professionals (IPDP) transition from Professional Development Record (PDR) July 1, 2014 to July 1, 2015 at which time it will be required for Keystone STARS providers. Copies of the PDR will no longer be available for ordering or downloading. * Please see the Clarifications section beginning on page 12 of this worksheet. WS4A-02 – SACC 7/1/15 Page 8 of 13 Name of Facility: __________________________________ MPI # on Certificate of Compliance: __________________ County: _____________________ LEARNING PROGRAM STARS Performance Standard & Documentation Pre-Designation Notes 2. A written Improvement Plan is developed to address any average facility score between 5.00 and 5.25 and any ERS subscale score below a 4.25 and STARS Technical Assistance is accessed to support implementing improvement goals. Written Improvement Plan addressing any average facility score between 5.00 and 5.25 and any subscale scores below 4.25 in the Keystone STARS ERS assessment Note: This is not required to request designation. An ERS assessment will be scheduled once your Regional Key designates all other STARS performance standards. Verified: Yes □ No □ Comments: Good Better Best Designation Notes Verified: Yes □ Comments: Good Better No □ Best changes associated with established goals. 1 Pennsylvania Core Knowledge Competencies for Early Childhood and School Age Professionals (CKC) replaced Core Body of Knowledge 2 Pennsylvania Big Ideas Framework (Big Ideas) and 3 Individual Professional Development Plan for Early Childhood and School-Age Professionals (IPDP) transition from Professional Development Record (PDR) July 1, 2014 to July 1, 2015 at which time it will be required for Keystone STARS providers. Copies of the PDR will no longer be available for ordering or downloading. * Please see the Clarifications section beginning on page 12 of this worksheet. WS4A-02 – SACC 7/1/15 Page 9 of 13 Name of Facility: __________________________________ MPI # on Certificate of Compliance: __________________ County: _____________________ PARTNERSHIPS WITH FAMILY AND COMMUNITY STARS Performance Standard & Documentation Community Resources / Family Involvement 1. A minimum of two family conferences are offered per year to discuss the child’s progress and behavioral, social and physical needs. Authentic assessments of the child are shared with the family a minimum of two times per year. (STAR 3) Dated copies of at least two family conference notices within the last 12 months are part of the child’s records Acknowledgement signed by family indicating receipt of child’s written report of progress. Pre-Designation Notes Notes: If the family does not attend the offered conference, a written procedure must be followed to give the family a copy of the written report. It is recommended that providers offer the conference and written report in the family’s primary language, if their knowledge of English is limited. Best practices will necessitate more frequent assessments for infants and toddlers Verified: Yes □ Designation Notes Verified: Yes □ Comments: No □ No □ Comments: Good Better Best Good Better Best 1 Pennsylvania Core Knowledge Competencies for Early Childhood and School Age Professionals (CKC) replaced Core Body of Knowledge 2 Pennsylvania Big Ideas Framework (Big Ideas) and 3 Individual Professional Development Plan for Early Childhood and School-Age Professionals (IPDP) transition from Professional Development Record (PDR) July 1, 2014 to July 1, 2015 at which time it will be required for Keystone STARS providers. Copies of the PDR will no longer be available for ordering or downloading. * Please see the Clarifications section beginning on page 12 of this worksheet. WS4A-02 – SACC 7/1/15 Page 10 of 13 Name of Facility: __________________________________ MPI # on Certificate of Compliance: __________________ County: _____________________ LEADERSHIP AND MANAGEMENT STARS Performance Standard & Documentation Pre-Designation Notes Continuous Quality Improvement 1. Provider develops and implements a Continuous Quality Improvement Plan using multiple sources. (STAR 3) Continuous Quality Improvement Plan with a list of at least 3 sources of information Optional Tool: STARS Continuous Quality Improvement Plan Instructions & Appendices STARS Resource Planning Guide Change of Directorship Notes: Sources of information for an annual evaluation/review of program may include surveys of families, staff, and/or school-aged children, ERS, LIS, audits, FPDP, etc. It is recommended that the Continuous Quality Improvement Plan be reviewed and updated annually. Verified: Yes □ No □ Comments: Good 2. A Strategic Plan is aligned with the program’s mission statement and put in place. Strategic plan is developed, implemented and reviewed annually Better Best Note: For additional information regarding Strategic Planning, you may access the Small Business Administration web site at http://sba.gov/ or the PA Small Business Development Centers web site at http://www.pasbdc.org/. Verified: Yes □ No □ Comments: Good Better Best Designation Notes Verified: Yes □ Comments: Good Better Verified: Yes □ Comments: Good Better No □ Best No □ Best 1 Pennsylvania Core Knowledge Competencies for Early Childhood and School Age Professionals (CKC) replaced Core Body of Knowledge 2 Pennsylvania Big Ideas Framework (Big Ideas) and 3 Individual Professional Development Plan for Early Childhood and School-Age Professionals (IPDP) transition from Professional Development Record (PDR) July 1, 2014 to July 1, 2015 at which time it will be required for Keystone STARS providers. Copies of the PDR will no longer be available for ordering or downloading. * Please see the Clarifications section beginning on page 12 of this worksheet. WS4A-02 – SACC 7/1/15 Page 11 of 13 Name of Facility: __________________________________ MPI # on Certificate of Compliance: __________________ County: _____________________ CLARIFICATIONS The Director is the person certified as “director” by DHS Certification. Professional Growth and Development Activities, as defined by Keystone STARS, include: For use in conjunction with Director and Staff Development 1. Active member of a professional organization (local, state or national) related to the field of early childhood or school age programs. 2. Member of a committee or board of an organization committed to child advocacy, OCDEL LEARN partners for early childhood education, or child development. 3. Attend, as a participant, a national, nationally affiliated, or statewide early learning conference. 4. Presenter, trainer, or instructor in child development/child care subjects in a class, training, workshop, or conference setting for staff, families, or community. 5. Author of published material on child development/child care subjects. 6. Serve as a Child Development Associate or School Age Credential Advisor or Assessor. 7. Mentor or provide consultation to another early childhood or school age program. 8. State/national accreditation observer, assessor, verifier, or endorser. 9. Supervisor of student teachers. 10. Coordinate and/or serve on a committee to coordinate an early learning conference. 11. Presenter, trainer or instructor in communications/community education subjects, such as media relations or becoming an ambassador for early education in your community, in a class, training, workshop or conference setting for staff, families or community. 12. Organizer or panelist/testifier in a leadership forum for community/school/business/or legislative leaders on early education in the community. 13. Organize a site visit of your facility for community/school/business leadership or public officials, including legislators. 14. Participate in research studies or survey opportunities. For use in conjunction with assistant level staff and aides only 1. Staff member is an aide who is enrolled in a CDA/CCP program. 2. Responsible for having written a response to a professional article (may be an internally submitted response). Approved Professional Development For each of the following types of professional development, the coursework must relate to the early childhood field, as outlined in the PA Core Knowledge Competencies (CKC), in order to meet the requirements for professional development under the Keystone STARS Performance Standards. o College credit coursework offered by approved institution of higher education o Act 45/48 professional development (credit or non-credit) o Continuing Education Units (CEU) o Professional development by a Pennsylvania Quality Assurance System (PQAS) approved instructor o Approved organization professional development WS4A-02 – SACC Page 12 of 13 7/1/15 Name of Facility: __________________________________ MPI # on Certificate of Compliance: __________________ County: _____________________ Staff includes the facility director, all teachers, and all care-giving staff employed at that site, which includes staff working less than 500 hours per year and working directly with the children. Staff also includes volunteers and substitutes working more than 500 hours per year. School-Age Child Care (SACC) Program: o If there are both SACC and younger age groups in the facility, they must meet their respective STARS performance standards in order to achieve a STAR designation. o Any staff persons who work between both SACC and younger age groups in the facility must meet the standard for the age group of primary focus. o If a SACC program is only open during the school year, the school year is considered its calendar/fiscal year. o For staff persons with primary focus in the School Age classroom, the School-Age Professional Credential (SAPC) is equivalent to a CDA. The o o o Provider should maintain the following information in each Child’s Record: Child’s full name Child’s Date of Birth Date Child enrolled in the program NEXT STEPS If you have any questions as you work toward completing the requirements for STAR 4, contact the STARS staff listed on the first page of this packet. When you believe that you meet the STAR 4 – Accreditation (Centers) performance standards, make sure that you have done the following: Completed each of the items in the STARS Performance Standards & Documentation column Completed the Request for STARS Designation Attached the facility’s current DHS Certificate of Compliance to the Request for STARS Designation Attached documentation of the facility’s accreditation status Attached the facility’s completed STARS Enrollment Calculation Tool Send the above documents to your Regional Key. WS4A-02 – SACC 7/1/15 Page 13 of 13